Death Foretold

Prophecy and Prognosis in Medical Care

This groundbreaking book explains prognosis from the perspective of doctors, examining why physicians are reluctant to predict the future, how doctors use prognosis, the symbolism it contains, and the emotional difficulties it involves. Drawing on his experiences as a doctor and sociologist, Nicholas Christakis interviewed scores of physicians and searched dozens of medical textbooks and medical school curricula for discussions of prognosis in an attempt to get to the core of this nebulous medical issue that, despite its importance, is only partially understood and rarely discussed.

"Highly recommended for everyone from patients wrestling with their personal prognosis to any medical practitioner touched by this bioethical dilemma."—Library Journal, starred review

"[T]he first full general discussion of prognosis ever written. . . . [A] manifesto for a form of prognosis that’s equal parts prediction-an assessment of likely outcomes based on statistical averages-and prophecy, an intuition of what lies ahead."—Jeff Sharlet, Chicago Reader

"[S]ophisticated, extraordinarily well supported, and compelling. . . . [Christakis] argues forcefully that the profession must take responsibility for the current widespread avoidance of prognosis and change the present culture. This prophet is one whose advice we would do well to heed."—James Tulsky, M.D., New England Journal of Medicine

Preface1. Prognosis in Medicine2. Making Use of Prognosis3. Error and Accountability in Prognostication4. Professional Norms Regarding Prognostication5. Telling Patients Their Prognosis6. The Self-Fulfilling Prophecy7. The Ritualization of Optimism and Pessimism8. A Duty to PrognosticateAppendix 1: Original Sources of DataAppendix 2: Detailed Survey Experiment ResultsAcknowledgmentsNotesBibliographyIndex

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